Free PETITION FOR EMANCIPATION - Connecticut

PETITION FOR EMANCIPATION
JD-JM-90 Rev. 1-97 C.G.S. Secs. 46b-150, 150b

STATE OF CONNECTICUT SUPERIOR COURT JUVENILE MATTERS

TO: THE SUPERIOR COURT FOR JUVENILE MATTERS:
ADDRESS OF COURT NAME OF MINOR CHILD ADDRESS OF CHILD SEX AGE DOCKET NO. DATE OF BIRTH

Name

NAMES OF PARENTS OR LEGAL GUARDIANS Relationship

Residence

PETITIONER

RESPONDENT

MINOR

FATHER

MOTHER

GUARDIAN

MINOR

FATHER

MOTHER

GUARDIAN

Wherefore, the Petitioner, requests that the court declare that the above-named minor is emancipated on the following statutory grounds: (1) The minor has entered into a valid marriage whether or not that marriage has been terminated by dissolution. (2) The minor is on active duty with any of the armed forces of the United States of America. (3) The minor willingly lives separate and apart from parents or guardian, with or without the consent of the parents or guardian, and that the mInor is managing his or her own financial affairs, regardless of the source of any lawful income. (4) For good cause shown, it is in the best interests of the minor, any child of the minor, or the parents or guardian of the minor.
STATE FACTS/REASONS FOR EMANCIPATION (Use additional sheet, if necessary)

SIGNED (Petitioner)

SUBSCRIBED AND SWORN TO BEFORE ME:

ON (Date)

SIGNED (Judge, Asst. Clerk, Notary, Comm. Sup. Ct )

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ORDER FOR HEARING AND SUMMONS Upon the foregoing petition, it is hereby ORDERED, that said petition be heard and determined at the Court Location shown below on the Hearing Date and time indicated, AND FURTHER ORDERED, that the respondent(s) named in this petition be and hereby are summoned to appear before the court on the Hearing Date and at the Court Location shown below by having a proper officer leave a true and attested copy of this order and summons with said respondent(s) or at the usual place of abode, or, if so ordered, by publication or mail on or before the date for service shown below and return same to the court. HEARING DATE COURT LOCATION
DATE NO., STREET AND TOWN PUBLICATION FOR: CERTIFIED MAIL FOR: TIME OF HEARING

.M.

SERVICE TO BE MADE ON OR BEFORE (Date) BY ORDER OF THE COURT (Signed - Judge/Clerk of Superior Court) DATE SIGNED

RIGHT TO COUNSEL:

If you wish an attorney but are unable to pay for one, upon proof of your inability to pay, the court will provide one for you. Any such request should be made immediately at the court office where your hearing is to be held.

RETURN OF SERVICE STATE OF CONNECTICUT
ss.

__________________________, Connecticut

________________COUNTY

On (date)____________________________20_____ then and there I served the foregoing petition, order, and summons on _______________________________________the person(s) named therein, by leaving with (cross out if abode) or at their usual place of abode of (cross out if in hand) the within named, a true and attested copy of the original petition, order, and summons. Attest:_________________________________________________ (Proper Officer)

STATE OF CONNECTICUT
ss.

__________________________, Connecticut

________________COUNTY

On (date)____________________________20_____ then and there I served the foregoing petition, order, and summons on _______________________________________the person(s) named therein, by leaving with (cross out if abode) or at their usual place of abode of (cross out if in hand) the within named, a true and attested copy of the original petition, order, and summons. Attest:_________________________________________________ (Proper Officer)

JD-JM-90 (Page 2) 1-97

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